Pregnancy Week By Week (Week 23)

Some Basic Pointers (Week 23)

Sugar in Urine

Non-diabetic women normally have a small amount of sugar in their urine. This is due to changes in sugar levels and how the kidneys handle sugar which in turn determine the amount of sugar in the system. Excess sugar is called glucosuria and is quite common during pregnancy, more so in the second and third trimesters. Pregnant women are usually tested for sugar levels at the end of the second trimester; testing is more rigorous if you have a family history of diabetes. These blood tests are termed glucose-tolerance test or GTT and fasting blood-sugar. In the latter test, you are required to eat normal meal the evening before the test. The next morning before having anything, you have to go to the lab and get a blood test done. A normal result will indicate that diabetes is absent while an abnormal test will indicate the reverse and further testing will be required. The next stage will be GTT where you will have to fast after dinner one night before the test. In the morning you will be given a solution to drink that has a measured amount of sugar in it. The sugar content is similar to a bottle of soda pop but it isn't as tasty. After you have had the solution, blood is drawn at intervals of about 30 minutes, 1 hour and then 2 or 3 hours. This will give some idea on how our body handles sugar. Your doctor will devise a plan for your treatment if required.

Diabetes and Pregnancy

Diabetes continues to be a problem during pregnancy; however women with this condition are equipped to deal with it safely during pregnancy thanks to medical care and nutrition and their doctor's good advice. Diabetes is a situation caused by a lack of insulin in the blood stream. Insulin is responsible for breaking down sugar and transporting it to the cells. The absence of insulin causes blood sugar to be high. There are two types of diabetes: Type 1 and Type 2. Type 1 causes body to stop the manufacture of insulin while Type 2 causes ineffective use of insulin. Type 2 is the more common one during pregnancy; but both types suggest too much sugar is circulating in the bloodstream. Problems caused by diabetes include kidney problem, eye problem, blood and vascular problems. These bear serious consequences for mother and baby. If diabetes is not controlled, you have chances of delivering a large baby; this increases your chance for a C-section, your risk of having preeclampsia and the baby is at greater risk of developing hypoglycemia (low blood sugar) and jaundice. One good way to maintain steady blood sugar is have all your meals; don't skip any meals, exercise in some measure, and adjust your insulin intake in terms of dosage and timings according to your needs during this time. Monitor your blood sugar at regular intervals. Insulin is safe during pregnancy.

Women who have trouble dealing with high blood sugar levels during pregnancy are more likely to develop diabetes later on in life. Symptoms include more frequent urination, blurred vision, weight loss, dizziness and hunger pangs. In some situations women acquire diabetes only during pregnancy - gestational diabetes - affecting about 10% of all pregnancies. After pregnancy, the problem disappears. However if gestational diabetes is found in one pregnancy, it will affect all subsequent pregnancies 90% of the time. This type of diabetes happens for 2 reasons: production of insulin drops during pregnancy and mother's body is not using insulin effectively. Both result in high blood-sugar levels. Without treatment gestational diabetes can be serious for mother and baby. Exposure to high levels of sugar is not healthy for both. You might experience high levels amniotic fluid and this can cause premature labor because uterus becomes over-distended. With a large baby on the way, long labor is quite expected, sometimes leading to a C-section. With high blood sugar levels chances of infections increases too, including those in bladder, kidneys, the cervix and the uterus. Treatment involves regular exercise and increased fluid intake. Diet has to change - a six meal diet, 2000-2500 calorie per day eating plan - as recommended by your doctor. A referral to a dietician may be necessary.

Your Nutrition (Week 23)

You may have to watch your salt intake during pregnancy. Excess sodium causes water retention leading to bloating and swelling. Avoid foods with high salt such as salted nuts, chips, pickles, canned foods and processed foods. Food labels will indicate the salt content per serving. However some foods have no indications like fast foods. You have to be careful there. Create the habit of reading labels before buying it off the shelf. Go easy on fast foods such as burgers and fries. Some foods with high salt content to give you an idea of what you are digging into: 

Food Serving Portion Sodium Content (mg)

Salt 1 teaspoon 1938

Hamburger 1 regular 96

Cola 8 oz 16

Oatmeal cup 52

Potato chips 20 regular 400

Cottage cheese 1 cup 580

American cheese 1 slice 322

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